CDC gets list of forbidden words: Fetus, transgender, diversity

The Trump administration is prohibiting officials at the nation's top public health agency from using a list of seven words or phrases — including "fetus" and "transgender" — in official documents being prepared for next year's budget.

Policy analysts at the Centers for Disease Control and Prevention in Atlanta were told of the list of forbidden words at a meeting Thursday with senior CDC officials who oversee the budget, according to an analyst who took part in the 90-minute briefing. The forbidden words are "vulnerable," "entitlement," "diversity," "transgender," "fetus," "evidence-based" and "science-based."

In some instances, the analysts were given alternative phrases. Instead of "science-based" or ­"evidence-based," the suggested phrase is "CDC bases its recommendations on science in consideration with community standards and wishes," the person said. In other cases, no replacement words were immediately offered.

The Department of Health and Human Services, which oversees the CDC, "will continue to use the best scientific evidence available to improve the health of all Americans," HHS spokesman Matt Lloyd told The Washington Post. "HHS also strongly encourages the use of outcome and evidence data in program evaluations and budget decisions."

The question of how to address such issues as sexual orientation, gender identity and abortion rights — all of which received significant visibility under the Obama administration — has surfaced repeatedly in federal agencies since President Trump took office. Several key departments — including HHS, as well as Justice, Education, and Housing and Urban Development — have changed some federal policies and how they collect government information about lesbian, gay, bisexual and transgender Americans.

In March, for example, HHS dropped questions about sexual orientation and gender identity in two surveys of elderly people.

HHS has also removed information about LGBT Americans from its website. The department's Administration for Children and Families, for example, archived a page that outlined federal services that are available for LGBT people and their families, including how they can adopt and receive help if they are the victims of sex trafficking.

At the CDC, the meeting about the banned words was led by Alison Kelly, a career civil servant who is a senior leader in the agency's Office of Financial Resources, according to the CDC analyst, who spoke on the condition of anonymity because the person was not authorized to speak publicly. Kelly did not say why the words are being banned, according to the analyst, and told the group that she was merely relaying the information.

Other CDC officials confirmed the existence of a list of forbidden words.It's likely that other parts of HHS are operating under the same guidelines regarding the use of these words, the analyst said.

At the CDC, several offices have responsibility for work that uses some of these words. The National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention is working on ways to prevent HIV among transgender people and reduce health disparities. The CDC's work on birth defects caused by the Zika virus includes research on the developing fetus.

The ban is related to the budget and supporting materials that are to be given to the CDC's partners and to Congress, the analyst said. The president's budget for 2019 is expected to be released in early February. The budget blueprint is generally shaped to reflect an administration's priorities.

Federal agencies are sending in their budget proposals to the Office of Management and Budget, which has authority about what is included.

The longtime CDC analyst, whose job includes writing descriptions of the CDC's work for the administration's annual spending blueprint, could not recall a previous time when words were banned from budget documents because they were considered controversial.

The reaction of people in the meeting was "incredulous," the analyst said. "It was very much, 'Are you serious? Are you kidding?' "

"In my experience, we've never had any pushback from an ideological standpoint," the analyst said.

News of the ban on certain words hasn't yet spread to the broader group of scientists at the CDC, but it's likely to provoke a backlash, the analyst said. "Our subject matter experts will not lay down quietly — this hasn't trickled down to them yet."

The CDC has a budget of about $7 billion and more than 12,000 employees working across the nation and around the globe on everything from food and water safety, to heart disease and cancer, to infectious disease outbreak prevention. Much of the CDC's work has strong bipartisan support.

Kelly told the analysts that "certain words" in the CDC's budget drafts were being sent back to the agency for correction. Three words that had been flagged in these drafts were "vulnerable," "entitlement" and "diversity." Kelly told the group the ban on the other words had been conveyed verbally.

Correction: This article originally misidentified CDC's Office of Financial Resources as the Office of Financial Services.

Lena H. Sun is a national reporter for The Washington Post, focusing on health.

Juliet Eilperin is The Washington Post's senior national affairs correspondent, covering how the new administration is transforming a range of U.S. policies and the federal government itself. She is the author of two books — one on sharks and another on Congress, not to be confused with each other — and has worked for The Post since 1998.